A clinical trial to compare the quality of life of HIV+ patients who start monotherapy with LPV/r versus continuing triple therapy with a boosted PI

Purpose of the study: Efficacy, toxicity and complexity of antiretroviral (ARV) regimens may impact the quality of life (QoL). Since over the past years the simplification approach of lopinavir/ritonavir (LPV/r) as monotherapy (MT) has been shown to be non-inferior to triple therapy (TT) in virological and immunological efficacy, the objective of this study was to compare several health- and treatment-related outcomes between both ARV strategies with LPV/r. Methods: A phase IV national, multicenter, controlled, randomized (2:1), open label, parallel-group clinical trial to compare the QoL in patients on ARV TT containing any boosted protease inhibitor (PI), undetectable viral load (VL< 50 cop/mL) in the past 6 months and a CD4 nadir > 100 cells/µL, versus those who were simplified to LPV/r MT, for 24 weeks. QoL and health outcomes were evaluated by the Medical Outcomes Study HIV Health Survey (MOS-HIV) and the five-dimensional EuroQol questionnaire (EQ-5D). Treatment satisfaction was assessed by the Spanish Questionnaire of Satisfaction with ARV Treatment (CESTA). Treatment adherence was assessed by the Spanish Multifactorial Adherence questionnaire (GEEMA) and a visual analog scale (VAS). Tolerability, safety and virological and immunological efficacy at week 24 were also analyzed. Summary of results: 225 patients from 29 sites were enrolled (MT: 146, 64.5%; TT: 79, 35.1%). Mean age (years) was 44.5 in MT and 45.2 in TT (p=0.745); mean duration (years) from HIV infection was 13.4 in MT and 12.8 in TT (p=0.587) and 71% were male in both arms. 87.6% of patients completed correctly the study (MT: 88.4%; TT: 86.1%; p=0.674). Health and treatment outcomes evaluated at final study visit are shown in figure 1 1. At study end, 84.1% in MT and 89.6% in TT had undetectable VL (p=0.313) and mean CD4 count were 742.8 cells/µL in MT and 646.5 cells/µL in TT (p=0.060). There were no significant differences in the percentage of patients with virological failure at week 24 as VL >50 cop/mL (MT: 8.2%; TT: 3.9%; p=0.271) and as VL >200 cop/mL (MT: 3.4%; TT: 0%; p=0.167). Conclusions: The MT simplification strategy with LPV/r maintains comparable virological and immunological efficacy, as well as the tolerability profile, than the TT. The saving resulting from NRTIs withdrawal from the ARV regimen and the good results on QoL and patients treatment satisfaction make MT strategy with LPV/r be taken into account in clinical practice

New record of Aedes Albopictus in a suburban area of Merida, Yucatan, Mexico

Along with Aedes aegypti (L.), Aedes albopictus has been implicated as a secondary vector for dengue virus, chikungunya virus, and Zika virus in Latin America. The article covers an entomological survey in 2018, in a suburban area of Merida (the largest and capital city in Yucatan). This is the first report of Ae. albopictus in a suburban area of Merida City. A total of 259 specimens were collected. It is important to consider the ecology of Ae. albopictus alongside that of Ae. aegypti when developing vector/disease control programs

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population

Fatal infection after rapamycin eluting coronary stent implantation

Septic complications after coronary stenting are extremely rare. The occurrence of cardiac related sepsis after rapamycin eluting stent deployment has not been previously reported. The potential role of drug eluting stents in locally blunting the innate response to bacterial agents is discussed

Właściwości fizyczne i plony ziarna kukurydzy w warunkach deszczowego zasilania w wodę w wysokich dolinach Meksyku

In the High Valleys of Mexico maize is produced with varied yield and quality which sometimes do not meet the parameters established by maize flour milling and nixtamalization industry for making tortilla. Therefore, an evaluation of the yields and quality of the grain of maize hybrids (Zea mays L.) and their relationship with the environment was performed. During the spring-summer cycle 2012, the hybrids HP-1, H-52, H-68, HP-2, H-70, Buho, HP-3, H-57E, H-64, Prospecto-1, H-72 and H-66 were evaluated in Texoloc and Benito Juárez (2240 and 2530 masl), Tlaxcala, Mexico in a design of completely randomised blocks with three replications. Grain yield (GY), thousand grain weight (TGW), hectolitric weight (HW), width (WG), length (LG) and thickness (TG) of grains were measured. The results showed highly significant differences (p = 0.01) between locations, hybrids and the interaction locality x hybrids for physical parameters. Among the localities, Texoloc had 86.59% and 24.32% higher GY and TGW compared to Benito Juarez, respectively, while the HW was slightly lower (73.68 kg hL-1). Average yields of the hybrids were 7.7 t ha-1; HP-2, HP-3, H-57E and H-66 hybrids had yields of more than 8 t ha-1 and the lowest yield was noted for H-70. The hybrids had an average HW of 74.30 kg hL-1; HP-1, H-68, H-70, Buho, HP-3 and H-72 had values > 74 kg hL-1, complying with the provisions of the quality standard NMX-FF034/1-SCFI- 2002 for maize destined for the nixtamalization process. The variation in agroclimatic conditions between the localities affected the yield and physical quality of maize grain.W Wysokich Dolinach Meksyku produkowana jest kukurydza o zróżnicowanej jakości i poziomie plonowania, która nie zawsze spełnia wymagania przemysłu młynarskiego i nixtamalizacji mąki kukurydzianej do produkcji tortilli. Z tego powodu przeprowadzono badania, mające na celu ocenę plonowania i jakości ziarna hybryd kukurydzy (Zea mays L.) oraz ich zależności od warunków środowiskowych. W sezonie wiosenno-letnim roku 2012 przeprowadzono badania na hybrydach HP-1, H-52, H-68, HP-2, H-70, Buho, HP-3, H-57E, H-64, Prospecto-1, H-72 oraz H-66 w Texoloc i Benito Juárez (2240 i 2530 m n.p.m.), Tlaxcala w Meksyku. Badania przeprowadzono w systemie bloków losowych, w trzech powtórzeniach, dokonując pomiarów plonu ziarna, masy tysiąca ziaren, masy hektolitra ziarna oraz szerokości, długości i grubości ziarna. Stwierdzono istotne różnice (p = 0,01) pomiędzy lokalizacjami, hybrydami oraz interakcjami lokalizacja- hybryda w zakresie parametrów fizycznych ziarna. Wartości plonu i masy 1000 ziaren w Texoloc były wyższe odpowiednio o 86,59% i 24,32% w porównaniu do wartości otrzymanych w Benito Juarez, podczas gdy wartość masa hektolitra była nieznaczenie niższa (73,68 kg·hL-1). Średni plon ziarna hybryd wyniósł 7,7 t·ha-1; plony hybryd HP-2, HP-3, H-57E i H-66 były powyżej 8 t·ha-1, a najniższy plon uzyskano dla hybrydy H-70. Średnia wartość masy hektolitra dla hybryd kukurydzy wyniosła 74,30 kg·hL-1; dla hybryd HP-1, H-68, H-70, Buho, HP-3 i H-72 były > 74 kg·hL-1, spełniając wymagania jakościowe normy NMX-FF034/1-SCFI-2002 dla kukurydzy przeznaczonej do procesu nixtamalizacji. Zróżnicowanie warunków agroklimatycznych pomiędzy badanymi lokalizacjami miało wpływ na plonowanie i charakterystyki fizyczne ziarna kukurydzy

Effectiveness and tolerability of abacavir-lamivudine-nevirapine (ABC/3TC/NVP) in a multicenter cohort of HIV-infected ARV-experienced patients

Purpose of the study: Very scarce information has been published to date with the combination of ABC/3TC/NVP but it is currently being used in clinical practice in many centers in Spain. Our aim was to present the clinical experience with this regimen in a cohort of adult HIV-infected pts. Methods: Retrospective, multicenter, cohort study. Consecutive adult HIV-infected ARV-experienced pts, HLA-B*5701-negative, who started ABC/3TC/NVP between 2005&#x2013;2010, with at least one follow-up visit, were included. Demographic, clinical and laboratory variables were assessed at baseline, month 1, and every 3&#x2013;4 months thereafter. The primary end point was HIV-1 viral load (VL) &#60;40 c/mL at 48 weeks. Data were analyzed by intent-to-treat (ITT) (non-completer=failure) and on treatment (OT). Summary of results: 227 pts were included and followed up for a median of 30 (0.5&#x2013;76) months. 75% male, 47 (24&#x2013;83) years, 21% AIDS, 13% HCV+, baseline CD4 570 (32&#x2013;1404) cells/&#x00B5;L and VL undetectable in 90% with a median of &#60;1.59 (&#60;1.59&#x2013;5.1) log. Most pts were receiving NVP (63%), ABC (25%) or both (4%) in the previous regimen. ABC/3TC/NVP was initiated due to toxicity (42%), simplification (35%) or other reasons (22%) including to reduce drug cost. After 48 weeks, VL was &#60;40 c/mL in 82% (ITT) and 94% (OT), and in 94% (OT) after 96 weeks. CD4 increased +63 (p&#60;0.001) and +77 (p&#60;0.001) cells/&#x00B5;L after 48 and 96 weeks, respectively. One or more drugs of the regimen were discontinued in 18% of pts during follow up: toxicity (7%), virologic failure (3%), lost to follow-up (3%), unrelated death (0.4%) or other reasons (4%). No significant differences were observed in ALT, AST, or triglyceride changes during follow up. A significant increase of 7%, 10% and 14% was observed in total cholesterol, LDLc and HDLc, and a significant decrease in TC/HDL ratio (&#x2212;5%, p=0.004) after 96 weeks, respectively. Conclusions: In this particular cohort of ARV-experienced pts previously receiving NVP or ABC, a combination of ABC/3TC/NVP was safe and mantained virologic suppression in the vast majority of pts, with rates similar to other switch strategies. A favourable lipid profile was observed after 96 weeks of follow up